Southside Virginia Training Center
NPI #1154330942 in Petersburg, Virginia
Provider Information
- NPI Number
- 1154330942
- Entity Type
- Organization
- Organization Name
- Southside Virginia Training Center
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Aug 8, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 26317 WEST WASHINGTON STREET
- City
- Petersburg
- State
- Virginia
- ZIP Code
- 23803
- Phone
- (804) 524-7209
Authorized Official
- Name
- DR. JOHN ALFRED HOLLAND JR., MD
- Title
- FACILITY DIRECTOR
- Phone
- (804) 524-7209
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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